As life expectancy increases, more emphasis has been placed on the importance of better QoL, and the maintenance of good health for as long as possible 6,7,8,9. Indeed, global leading health organizations have emphasized the importance of QoL and well-being as a goal across all life stages 10,11,12. As you can see from Table 1 below, HRQoL is multi-dimensional (contains multiple items and domains) including physical, psychological, fnctional, and social domains related to a person’s perception of quality of life affected by health status. HRQoL measurement therefore will attempt to capture QoL in the context of one’s health and illness addressing these domains.
The methodological quality of included studies based on NOS ranged between five and nine stars. Among the included studies, seven were of high methodological quality, with nine stars. Mental Health is important at every stage of life and includes our emotional, psychological, and social well-being.
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- Most of the studies included in this review, did not undertake such analyses.
- While the use of QoL as a treatment outcome would likely have many benefits, incorporating QoL discussions during care involves a number of practical challenges.
- Strong theoretical research provides direction for methods and application research.
- Overall QOL is described as the discrepancy between a person’s expectations or hopes and his or her present experiences.
- Actions include funding good public schools, offering affordable access to healthcare, and supporting family-friendly policies like paid leave to take care of sick family members or newborn or adopted children.
The issue at hand then is if QoL should be the primary driving factor for lifestyle medicine in general. Instead of simply assuming that interventions are improving QoL because they treat disease, should the impact of interventions from a QoL perspective be considered first? In order to address this question, multiple factors should be considered that are both practical and philosophical in nature.
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Given the heterogeneity identified in the three meta-analyses described above, the influence of individual studies on the pooled risk estimate was assessed. The removal of no single study affected the association (Supplementary Table S8 – S10, Additional File 1). EUPATI in its documents uses the term health related quality of life (HRQoL) to avoid different interpretations.
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Since our review criteria were not limited to articles with the commonly used QoL (or HRQoL) tools such as the SF-36, this has increased the generalisability of the findings. Therefore, this review has a broad and comprehensive perspective, with results that are rigorous and can be reproduced. Given the evidence regarding the longitudinal relationship between QoL and mortality risk, the utility of a QoL tool in general care may improve patient’ health which in turn would decrease mortality. Furthermore, mental health issues such as depression or anxiety could also be identified through QoL measures and this would enable initiation of early interventions for mental health which in turn could improve long term QoL of individuals.
Among included articles, large heterogeneity was observed in terms of country-of-origin, participant characteristics, and evaluation of QoL. The majority of the included articles were conducted in English speaking counties, and restriction to English language articles as part of our inclusion criteria, may impact the generalisability of these findings. Since the different QoL standard tools examine different aspects 33, 85 and are not directly comparable, this made comparison of included studies in data synthesis difficult. There were also some differences in the way the data analysis was performed and the results were presented, reporting OR versus HR for example.
- Since QoL measures outcomes beyond biological functioning and morbidity 2, it is recognised as an important measure of overall 1.
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- Andy Smith is a Certified Financial Planner (CFP®), licensed realtor and educator with over 35 years of diverse financial management experience.
- Five studies included only males 41, 42, 54, 71, 73 and three studies only females 56, 59, 74.
- While everyone’s idea of a high-quality life varies, there are some universal markers.
What is Health Related Quality of Life
No article distinguished “overall” QOL from HRQOL.27 To reverse this situation, many theorists, researchers, organizations, and consensus groups have proposed a definition of QOL or HRQOL. The International Society for Quality of Life Research (ISOQOL) is a global community of researchers, clinicians, health care professionals, industry professionals, consultants, and patient research partners advancing health related quality of life research (HRQL). Researchers use assessments (interviews, surveys, questionnaires, scales) and symptom tracking to help determine life quality. Other times, researchers take a multi-perspective approach, collecting feedback from patients, their caregivers, clinicians and observers, health-related devices, and other sources. Other organizations, however, may also work towards improved global quality of life using a slightly different definition and substantially different methods.
Hence, the finding of this review can help to increase the efficacy of disease prevention strategies in older people through identifying individuals at higher risk for adverse health outcomes in general practice / primary health settings. Thus, the mortality risk prediction by QoL might not be very relevant to younger healthy populations although QoL generic measures were designed to be used across a wide range of populations 84. There is a need for further studies however, in particular to better understand the influence of gender on these associations, and whether differences could be observed for males and females. Understanding these specific relationships could help identify which particular groups are most at risk and enable specific targeting of interventions to these individuals. A recognition of how physical health and quality of life (QoL) are related is at the center of much of the care that is provided in lifestyle medicine.1-3 However, the primary focus of most treatment and research is how to best treat a disease state.
However, since happiness is subjective and difficult to measure, other measures are generally given priority. Standard of living focuses on the quantifiable aspects of life, such as income, employment opportunities, and access to goods and services, while quality of life focuses on the personal and subjective side, such as happiness, mental well-being, freedom, and fulfillment. Standard of living is a financial measure while quality of life captures how satisfying life is. However, HRQoL represents a subjective appraisal of the impact of illness or its treatment; individual patients with the same objective health status can report dissimilar HRQoL due to unique differences in expectations and coping abilities. As a result, HRQoL should be measured from the individual’s viewpoint rather than that of outside observers (i.e., caregivers or healthcare quality of life definition professionals) and is a PRO. A popular model of QOL is provided by Wilson and Cleary.30 This conceptual model links physiological variables, symptom status, functional health, general health perceptions, and overall QOL (Figure 3).
Today, it is common to weigh both salary and quality of life when considering how good or bad a job is. The WHOQOL is a quality of life assessment developed by the WHOQOL Group with fifteen international field centres, simultaneously, in an attempt to develop a quality of life assessment that would be applicable cross-culturally. Wilson’s theories have been used to justify the implementation of zero tolerance policies by many prominent American mayors, most notably Oscar Goodman in Las Vegas, Richard Riordan in Los Angeles, Rudolph Giuliani in New York City and Gavin Newsom in San Francisco.
In addition, some articles reported the risk estimates by comparing categorical QoL groups while others provided the risk estimates per 1 or more units change in the continuous scale. Hence, the different nature of each QoL scale and inconsistency in risk comparison precluded us from including some articles in the meta-analyses. As such, only 11 studies were included across the four meta-analyses of this systematic review, and the meta-analyses still showed substantial heterogeneity.
Crewe appears to be the first researcher to publish a QOL study in persons with SCI. They also included one item on overall QOL, thereby covering health status or HRQOL and SWB. The terms ‘patient health status’ and ‘functional status’ have also been used to mean HRQoL, despite the fact that these measures do not strictly require information from the patient’s perspective – that is, they are not necessarily patient reported outcomes (PROs).